The aim of this study was to quantify and where possible objectively confirm the magnitude of non-compliance (NC) in our paediatric renal transplant recipients. A total of 94 paediatric transplants were performed between 1984 and 1989; 17 were excluded due to graft loss (2), death (3), oxalosis (2) and transfer to the adult unit (10). NC was assessed as missed clinic visits plus medication shortages or actual admission of NC. NC was found in 22% (17/77) of transplanted patients. NC showed no correlation with parental marital status, sex, distance lived from the hospital, pre-emptive transplant status or total lymphoid irradiation. Most NC was peripubertal with a smaller NC in the late teenager group. Social class correlated positively with NC; 82.3% of NC was from social classes III and IV, who formed 52.4% of the patients. NC in social class II (3/26) was significantly different from social class IV (12/24) (P=0.01); 91% of black patients with NC were from social class IV. Race, corrected for social class, failed to reach significance (P>0.05). Confirmation of compliance was sought from retrospective cyclosporin A (CsA) trough levels (twice daily dosage). Concomitant phenytoin therapy and CsA given as a daily dosage were excluded as significant confounding variables. The CsA dosage was not significantly different between the compliant (C) and patients with NC. Patients with NC were 8 times more likely to have a CsA level<10 ng/ml (P=0.0026) than C patients. Patients with NC have needed more grafts (P=0.037), have a shorter graft survival, have lost more grafts (P=0.0003), and more have died (P=0.0197), than C patients.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Chadwick J, Nann WN (1950) The medical works of Hippocrates. Thomas, Springfield, Illinois
Dunn J, Golden D, Van Buren CT, Lewis RM, Louen J, Kahan BD (1990) Causes of graft loss beyond two years in the cyclosporin era. Transplantation 49: 349–353
Rovelli M, Plameri D, Vassler E Bartus, S, Hull D, Schweizer R (1989). Non-compliance in renal transplant recipients: evaluation by socioeconomic groups. Transplant Proc 21: 3979–3981
Delone P, Trollinger J, Fox N, Light J (1989) Noncompliance in renal transplant recipients; methods for recognition and intervention. Transplant Proc 21: 3982–3984
Korsch BM, Fine RN, Negrete VF (1978) Noncompliance in children with renal transplants. Pediatrics 61: 872–876
Mc Donald JC (1989) Comment. Issues related to race in transplantation. Transplant Proc 21: 3411–3412
Office of Population Censuses and Surveys (1970) Classification of occupations 1970. HMSO, London, pp 10, 93–101
Fine RN, Tejani A (1987) Renal transplantation in children. Nephron 47: 81–86
Beck DE, Fennell RS, Yost RL, Robinson JD, Geary MB, Richards GA (1980) Evaluation of an educational program on compliance with medication regimens in pediatric patients with renal transplants. J Pediatr 96: 1094–1097
Rovelli M, Palmeri D, Vossler E, Bartus S, Hull D, Schweizer R (1989) Noncompliance in organ transplant recipients. Transplant Proc 21: 833–834
Becker HM, Drachman RH, Kirscht JP (1972) Predicting mother's compliance with pediatric medical regimens. J Pediatr 81: 843–854
Meichenbaum D, Turck DC (1987) Facilitating treatment adherence, 1st edn. Plenum, New York, pp 40–65
Didlake RH, Dreyfus K, Kerman RH, Van Buuren CT, Kahan BD (1988) Patient noncompliance: a major cause of late graft failure in cyclosporin-treated renal transplants. Transplant Proc 20: 63–69
Myburgh JA, Meyers AM, Thomson PD, Botha JR, Margolius L, Lakier R, Smith JA, Stark JH, Gray C (1989) Total lymphoid irradiation: current status. Transplant Proc 21: 826–828
Schweizer RT, Rovelli M, Palmeri D, Vossler E, Hull D, Bartus S (1990) Noncompliance in organ transplant recipients. Transplantation 49: 374–377
About this article
Cite this article
Meyers, K.E.C., Weiland, H. & Thomson, P.D. Paediatric renal transplantation non-compliance. Pediatr Nephrol 9, 189–192 (1995). https://doi.org/10.1007/BF00860742
- Renal transplantation
- Cyclosporin A